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An Epidemiological Profile of Prescription Drug and Opioid Use in Illinois

November 30, 2017
By: Illinois Statewide Epidemiological Outcomes Workgroup

Introduction/Executive Summary

This epidemiological profile of prescription drug use in Illinois was developed as part of a collaborative effort with the Illinois Statewide Epidemiological Outcomes Workgroup (SEOW). The purpose of this epidemiological profile is to explore and understand the emerging issue of prescription drug misuse in Illinois. The profile provides data from recent years regarding the consumption and prevalence, contributing factors, and consequences related to the misuse of prescription drugs. As part of the Strategic Prevention Framework-Partnerships For Success project, the SEOW was tasked with investigating the current state of prescription drug misuse in the state of Illinois, and the data available to illustrate the issue.

The data sources included in this epidemiological profile are described in depth in the Appendix A, but include primarily survey data from a variety of state and national instruments, as well as other archival sources for mortality and treatment data. Survey question wording varies from instrument to instrument, so the exact question wording and response options are outlined in Appendix B. Each section throughout the profile begins with a brief introduction and related research, followed by a synopsis of the data presented in the charts, tables, and maps. When available, both trend and comparison data were presented.

Prescription drug misuse and opioid abuse have recently become the forefront of many initiatives in the state of Illinois, due in large part to the recent increases in rates of consequences, such as overdose deaths. These issues are often complex and ever-changing. This epidemiological profile cast a wide net in terms of the inclusion of data. The hope was to provide a wide spectrum of information related to the misuse of prescribed drugs and opioids. As a result, a broad range of issues were included, such as related drug use and consequences. Opioid misuse included synthetic, natural, prescribed, or illegally produced whenever available, though these varying types of opioids are not often specified or easily determined via test results. Heroin use was also considered, as research linking prescription drug misuse and subsequent heroin use has been established (Jones, 2013).

Due to the nature of prescription drug and opioid abuse, there are many areas within the data provided that could be further explored. Several agencies around the state of Illinois have recently begun to do this in separate reports (Chicago Department of Public Health, 2017; Illinois Department of Human Services, 2017; Illinois Department of Public Health, 2017). These reports provide a more in-depth analysis of treatment data and locations, Naloxone administrations, and data for the city of Chicago specifically that were beyond the scope of this epidemiological profile.

Major Findings

As expected, the consumption and prevalence data revealed that use of prescription drugs increases with age. Also, those youth who report using prescription drugs are more likely to be using other drugs (poly-drug use) and use more frequently as they age. Overall, the trend data showed a decrease for all grades (8th, 10th, and 12th) regarding prescription painkiller use to get high, but “other” prescription drug use (Ritalin, Adderall, Xanax, etc.) was increasing for all grades. Heroin use was low, comprising only 1-2% of youth. For college students, it appears that stimulants were the most commonly used type of prescription drug, which seemed to align with the “other” prescription drugs in 8th-12th grade youth.

The demographics of prescription drugs users indicated that users are typically Caucasian or Latino, male, have a lower socioeconomic status, and range in age between 18 and 25 years old. Looking across the youth survey data, it also appears that prescription drug misuse occurs more frequently in rural areas.

When compared to national data, it appears that Illinois is lower for prescription drug use across the board. The only exception to this was the Youth Risk Behavior Survey (YRBS) that showed heroin was higher for lifetime use in 9th, 11th, and 12th grades in Illinois, but again the rates were low overall (2.8 to 4.6%).

Contributing factors data showed that the majority of youth still disapprove, and believe their parents and peers disapprove, of misusing prescription drugs. Related, roughly 65% of all youth perceived “great risk” in misusing prescription drugs. The perception of peer use was much higher for college students than actual use, with most students believing 50-65% were using some type of prescription drug, when actually only about 2-6% reported using.

Access to prescription drugs was also examined. Older youth tended to perceive easier access to prescription drugs. The source of prescription drugs for 8th-12th grade youth varied by age. Eighth grade youth reported higher access from parents, while 12th grade students reported higher access from someone other than their parent or purchasing them. The vast majority of college students reported getting access to drugs from legitimate prescriptions, with the exception of stimulants (also the most commonly used type) which they reported getting from friends at school.

Depression and suicidality was higher for prescription drug users for every grade in every scenario on both the Illinois Youth Survey and YRBS, with the exception of the most serious indicator, suicide attempts that resulted in being treated by a doctor or nurse in grades 10th, 11th, and 12th. This suggests a strong relationship between mental health issues and prescription drug misuse.

When looking at the consequences related to prescription drug misuse, drug treatment admission data, emergency room visits, Naloxone administrations, and overdose mortality were considered. Drug treatment admission data for age at admission supported the findings that prescription drug misuse is a young adult problem, with the highest treatment admissions being for the 26-30 age group (just past the 18-25 age group for highest users reported by NSDUH). Heroin showed similar results, with an additional spike in the 41-45 age group. Heroin and marijuana were the most common primary substance of abuse for drug treatment admissions.
Reported Emergency Medical Services (EMS) administration of Naloxone and emergency room visit data are presented as maps by county, and support the IYS strata data that showed prescription drug misuse has more consequences in rural areas. According to Census data, of the 14 counties that had the highest incidences of Naloxone administrations by EMS personnel, all of the counties had small populations ranging from 5,788 to 51,441 with an average population of 23,237. Comparatively, for the 13 counties that had the highest rates of emergency room visits for prescription drug-related poisonings, populations ranged from 5,265 to 52,521 with an average population of 23,149 people. Most of these counties were in the southern half of the state for both Naloxone administrations and emergency department visits. By contrast, the average population of a county in the state of Illinois is 126,078.

Opioid overdose deaths have become a particular point of concern in recent years (Rudd, Aleshire, Zibbell, and Gladden, 2016). The data for Illinois show that opioid deaths comprise a majority of all drug overdose deaths, accounting for 71% of overdose deaths on average for the past 4 years. The rate of prescription opioid overdose deaths per 100,000 has increased every year for the past 3 years. In 2015, the number of prescription opioid deaths in Illinois was in the second highest quartile when compared with other states. Similar to consumption and hospital data, the highest percentage of deaths occurred in the 25-34 age range. Perhaps one of the most alarming findings was overdose deaths by drug type. Between 2010 and 2015 the number of heroin overdose deaths increased from 150 to 844. The largest jump occurred between 2012 and 2013, when the number of deaths tripled. From 2014 to 2015, there was also a sharp increase in overdose deaths from synthetic opioids, which have been increasing in popularity (Lucyk and Nelson, 2017). Overdose deaths by county occurred in various locations around the state (northern, southern, and central). Of the 10 counties with the highest rates of overdose deaths from opioids, two were urban and 8 were rural. The rural counties had an average population of 21,334. Again the problem appears more often in rural counties.


While it appears that overall the problem of prescription drug misuse in Illinois is lower than other states, the problem is increasing. The data revealed that the problem mostly occurs with young adults and the consequences are increasing at a staggering rate. It will be important to monitor prescription drug misuse going forward, and design effective strategies to prevent access to these dangerous drugs.


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